Phase II trial of fludarabine phosphate in lymphoma: an effective new agent in low-grade lymphoma.

1992 ◽  
Vol 10 (5) ◽  
pp. 790-794 ◽  
Author(s):  
J R Redman ◽  
F Cabanillas ◽  
W S Velasquez ◽  
P McLaughlin ◽  
F B Hagemeister ◽  
...  
Keyword(s):  
Phase Ii ◽  
Phase Ii Trial ◽  
Cell Lymphoma ◽  
Large Cell ◽  
Complete Response ◽  
Low Grade ◽  
High Grade ◽  
Major Activity ◽  
Fludarabine Phosphate ◽  
Large Cell Lymphoma

PURPOSE In a phase II trial we investigated fludarabine phosphate (FAMP) as therapy for patients with relapsed lymphoma to determine its effectiveness and toxicity in this disease. PATIENTS AND METHODS The 67 assessable patients had a median age of 56 years and had received a median of three chemotherapy regimens before treatment with FAMP. The starting dose was 25 mg/m2 administered intravenously over 30 minutes daily for 5 days every 3 to 4 weeks. RESULTS High response rates were observed for follicular small cleaved-cell lymphoma (FSCCL) (62%), follicular mixed small- and large-cell lymphoma (80%), and follicular large-cell lymphoma (FLCL) (100%). Responses also occurred in small lymphocytic lymphoma (SLL) (33%), transformed lymphoma (33%), mycosis fungoides (40%), and Hodgkin's disease (25%). No responses were observed in other intermediate- or high-grade lymphomas (N = 20). Overall, there were five patients with a complete response, 23 patients with a partial response, and an overall response rate of 37%. Toxicity was primarily hematologic and infectious. No significant gastrointestinal, hepatic, renal, or neurologic toxicity occurred. CONCLUSIONS We conclude that FAMP has major activity in follicular lymphoma. Fundamental research is needed to understand this differential efficacy in low-grade lymphoma yet lack of efficacy in intermediate- and high-grade lymphoma. Clinical investigations should be done using FAMP in varying dose schedules and in combination regimens.

Phase II trial of paclitaxel by 24-hour continuous infusion for relapsed non-Hodgkin's lymphomas: Southwest Oncology Group trial 9246.

1998 ◽  
Vol 16 (2) ◽  
pp. 574-578 ◽  
Author(s):  
O W Press ◽  
M LeBlanc ◽  
T J O'Rourke ◽  
S Gagnet ◽  
R A Chapman ◽  
...  
Keyword(s):  
Continuous Infusion ◽  
Phase Ii ◽  
Phase Ii Trial ◽  
Single Agent ◽  
Complete Response ◽  
Low Grade ◽  
High Grade ◽  
Oncology Group ◽  
Southwest Oncology Group ◽  
Hodgkin's Lymphomas

PURPOSE The Southwest Oncology Group (SWOG) recently conducted a multiinstitutional phase II trial to determine the complete response (CR) and partial response (PR) rates, toxicities, and progression-free and overall survivals of patients with relapsed non-Hodgkin's lymphomas (NHLs) treated with a 24-hour continuous infusion of paclitaxel at a dose of 175 mg/m2. PATIENTS AND METHODS Sixty-six patients with relapsed NHL who had received minimal prior therapy (one prior chemotherapy regimen for intermediate- to high-grade NHL [44 patients] or one or two prior regimens for low-grade NHL [22 patients]) were premedicated with dexamethasone, diphenhydramine, and cimetidine and then treated with continuous intravenous infusion paclitaxel over 24 hours every 21 days. RESULTS Eleven of 66 patients (17%) achieved rigorously documented objective remissions, including two CRs (3%) and nine PRs (14%). In addition, another five patients (8%) achieved apparent PRs on a single computed tomographic (CT) scan. Responses were brief, lasting a median of 3 months (5 months for indolent lymphomas and 3 months for intermediate- to high-grade lymphomas). Grade 4 or 5 granulocytopenia was the only common serious toxicity, and occurred in 42 of 66 patients (64%). CONCLUSION Paclitaxel is generally well tolerated when given as a continuous infusion of 175 mg/m2 over 24 hours, despite predictable granulocytopenia. However, single-agent paclitaxel has modest clinical efficacy compared with other available treatments for relapsed NHL.

Results of a Prospective Phase II Trial of Limited and Extended Rituximab Treatment in Nodular Lymphocyte Predominant Hodgkin’s Disease (NLPHD).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 644-644 ◽  
Author(s):  
Sandra J. Horning ◽  
Nancy L. Bartlett ◽  
Sheila Breslin ◽  
Ranjana H. Advani ◽  
Richard T. Hoppe ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Phase Ii ◽  
De Novo ◽  
Phase Ii Trial ◽  
Cell Lymphoma ◽  
Large Cell ◽  
Extended Treatment ◽  
Prospective Phase ◽  
Large Cell Lymphoma

Abstract Background: NLPHD represents a unique clinical entity characterized by limited peripheral nodal disease, an indolent behavior with a frequent relapse pattern following radiotherapy or chemotherapy, and late treatment-related effects. Distinct from classical HD, the malignant cells of NLPHD are universally CD20+ and we therefore postulated that rituximab may have activity with fewer adverse effects. Methods: In this prospective phase II trial, patients (pt) with untreated or relapsed CD20+ NLPHD and measurable disease were eligible to receive four weekly doses of rituximab at 375 mg/m2. Restaging studies after completion of all treatment were performed at 1, 3 and 6 months (mo), and every 6 mo thereafter to progression. Endpoints were estimated response rate, freedom from progression (FFP) and safety. We previously reported that FFP was less than 1 year despite the fact that all patients responded to a limited, weekly × 4 treatment (Ekstrand et al. Blood101:4285, 2003). The protocol was then modified to repeat 4 weekly 375 mg/m2 doses at 6 mo intervals for 2 yr. One patient received an extended rituximab course after progression on the limited course. Results: Pt received limited (n=23, 12 previously untreated) or extended (n=16, 9 previously untreated) rituximab. Median age at treatment was 44 yr (17–71) with 26 males. Among 21 previously untreated pt, stages were I (6), II (8), or III (7). Median follow-up is 60 months (mo) for all pt, 72 mo for limited and 30 mo for extended treatment pt. Treatment-related adverse events were minimal and no grade 3 or 4 toxicities were reported. All but 1 pt responded (OR 97%) with CR/CRu in 27 (69%), and PR in 11 (28%) and SD in 1 (3%). CR/CRu was achieved in 56% limited and 88% extended rituximab pt (p=0.08). No difference was observed in previously treated v untreated pt. To date, 17 progressions (15 limited, 2 extended rituximab) have been recorded. Median FFP was 24 mo for limited and not reached for extended rituximab (p=0.03). FFP at 30 months was estimated at 52% for limited rituximab and 88% for extended rituximab pt. Four pt transformed to large cell lymphoma (one after multiple relapse treatments). Three deaths occurred, one each due to colon cancer, acute leukemia (pt heavily pre-treated with radiation and MOPP), and large cell lymphoma. For all 38 pt, median follow-up from diagnosis is 7.5 yr (range (<1–38) and survival from diagnosis is estimated at 97% at 10 yr and 85% at 20 yr. Conclusions: Rituximab is an effective treatment in de novo or recurrent NLPHD that may be associated with fewer adverse effects than conventional therapy. FFP is prolonged with an extended treatment but additional follow-up is needed to better assess the duration of benefit.

scholarly journals Phase II trial of dose-adjusted EPOCH in untreated systemic anaplastic large cell lymphoma

Haematologica ◽  
2015 ◽  
Vol 101 (1) ◽  
pp. e27-e29 ◽  
Author(s):  
K. Dunleavy ◽  
S. Pittaluga ◽  
M. Shovlin ◽  
M. Roschewski ◽  
C. Lai ◽  
...  
Keyword(s):  
Phase Ii ◽  
Anaplastic Large Cell Lymphoma ◽  
Phase Ii Trial ◽  
Cell Lymphoma ◽  
Large Cell ◽  
Large Cell Lymphoma

scholarly journals A Phase II Study of SGN-30 in Cutaneous Anaplastic Large Cell Lymphoma and Related Lymphoproliferative Disorders

2009 ◽  
Vol 15 (19) ◽  
pp. 6217-6224 ◽  
Author(s):  
Madeleine Duvic ◽  
Sunil A. Reddy ◽  
Lauren Pinter-Brown ◽  
Neil J. Korman ◽  
John Zic ◽  
...  
Keyword(s):  
Phase Ii ◽  
Anaplastic Large Cell Lymphoma ◽  
Phase Ii Study ◽  
Cell Lymphoma ◽  
Large Cell ◽  
Lymphoproliferative Disorders ◽  
Large Cell Lymphoma

Bone marrow involvement by non-Hodgkin's lymphoma: the clinical significance of morphologic discordance between the lymph node and bone marrow. Nebraska Lymphoma Study Group.

1990 ◽  
Vol 8 (7) ◽  
pp. 1163-1172 ◽  
Author(s):  
M G Conlan ◽  
M Bast ◽  
J O Armitage ◽  
D D Weisenburger
Keyword(s):  
Bone Marrow ◽  
Lymph Node ◽  
T Cell ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
Large Cell ◽  
Small Cell ◽  
Low Grade ◽  
High Grade ◽  
Lymphoid Aggregates

Bone marrow specimens from 317 patients with non-Hodgkin's lymphoma (NHL) obtained at initial staging were evaluated for the presence of lymphoma or benign lymphoid aggregates. Thirty-two percent (102 patients) had lymphoma in their bone marrow, and 9% had benign lymphoid aggregates. Bone marrow lymphoma was present in 39% of low-grade, 36% of intermediate-grade, and 18% of high-grade lymphomas. The bone marrow was involved in 25% of patients with diffuse large-cell or immunoblastic NHL (ie, diffuse histiocytic lymphoma of Rappaport). Bone marrow involvement did not affect survival of patients with low-grade NHL, but survival was significantly shorter (P = .03) for patients with intermediate- and high-grade NHL with bone marrow involvement. Bone marrow involvement was equally common in B-cell and T-cell NHL (31% v 32%). However, patients with T-cell NHL and bone marrow involvement had shorter survival than B-cell NHL with marrow involvement (P = .02) or T-cell NHL without marrow involvement (P = .05). A high incidence of morphologic discordance between lymph node and bone marrow was observed (ie, 40%), always with a more aggressive subtype in the lymph node than in the bone marrow. Presence of large-cell lymphoma in the bone marrow predicted for short survival. Survival for patients with small-cell lymphoma in their bone marrow did not differ significantly from patients with negative bone marrows. We conclude that bone marrow involvement in large-cell NHL, especially in those of T-cell origin, portends a poor prognosis. However, the subgroup of patients with an aggressive histologic subtype of NHL in a lymph node biopsy and small-cell NHL in the bone marrow do not have a poorer outlook than those without bone marrow involvement.

Complete Response of Relapsed Systemic and Cutaneous Anaplastic Large Cell Lymphoma Using Brentuximab Vedotin: 2 Case Reports

2013 ◽  
Vol 13 (4) ◽  
pp. 493-495 ◽  
Author(s):  
Alessandro Broccoli ◽  
Enrico Derenzini ◽  
Cinzia Pellegrini ◽  
Riccardo Narducci ◽  
Giulia Stefani ◽  
...  
Keyword(s):  
Anaplastic Large Cell Lymphoma ◽  
Cell Lymphoma ◽  
Case Reports ◽  
Large Cell ◽  
Complete Response ◽  
Brentuximab Vedotin ◽  
Large Cell Lymphoma

COPBLAM III: infusional combination chemotherapy for diffuse large-cell lymphoma.

1988 ◽  
Vol 6 (3) ◽  
pp. 425-433 ◽  
Author(s):  
D B Boyd ◽  
M Coleman ◽  
S W Papish ◽  
A Topilow ◽  
S K Kopel ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Combination Chemotherapy ◽  
Cell Lymphoma ◽  
Large Cell ◽  
Complete Response ◽  
The Elderly ◽  
Diffuse Large Cell Lymphoma ◽  
Large Cell Lymphoma ◽  
The Difference

COPBLAM III, a polychemotherapy regimen consisting of cyclophosphamide, infusional vincristine, prednisone, infusional bleomycin, doxorubicin, and procarbazine, was administered to 51 patients with diffuse large-cell lymphoma. Ninety-six percent of patients age 60 or younger achieved a complete response (CR); none have relapsed. Overall, 88% of patients are alive and well and potentially in the survival plateau. For patients greater than 60 years, CR was obtained in 73%, with 42% potentially in the survival plateau, the difference resulting in part from four relapses, three toxic deaths, and one presumed unrelated death. These results in the elderly were paralleled by a relatively reduced ability to tolerate therapy. Toxicity was primarily pulmonary, occurring in 39% of patients, two of whom died. With an overall CR rate of 84%, of which 92% are sustained at a median follow-up of 40 months, COPBLAM III represents a highly effective treatment in a sizeable cohort of patients.

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